60 nations see vaccines trickle
India factory halts exports, turns off tap
LONDON — As many as 60 countries, including some of the world’s poorest, are facing a delay of months in receiving the first shots of their coronavirus vaccinations because nearly all deliveries through the global program intended to help them are blocked until as late as June.
COVAX, the global initiative to provide vaccines to countries that lack the clout to negotiate for the scarce supplies themselves, has in the past week shipped more than 25,000 doses to low-income countries only twice on any given day. Deliveries have all but stopped since Monday.
During the past two weeks, according to data compiled daily by UNICEF, fewer than 2 million COVAX doses in total were cleared for shipment to 92 countries in the developing world — the same amount
that has been injected in Britain alone.
On Friday, the head of the World Health Organization slammed the “shocking imbalance” in global covid-19 vaccinations. WHO Director General Tedros Adhanom Ghebreysus said that while one in four people in rich countries had received a dose of vaccine, only one in 500 people in poorer countries had gotten one.
The vaccine shortage stems mostly from India’s decision to stop exporting vaccines from its Serum Institute factory, which produces the overwhelming majority of the AstraZeneca doses that COVAX counted on to supply about a third of the global population. The shortage of vaccine comes at a time when coronavirus cases are spiking worldwide.
COVAX will ship only vaccines cleared by WHO, and countries are increasingly impatient. Supplies are dwindling in some of the first countries to receive COVAX shipments, and the expected delivery of second doses within the recommended 12-week window is now in doubt. The vaccine alliance known as GAVI told The Associated Press that 60 countries are affected by the delays.
In vaccination tents set up at Kenyatta National Hospital in Nairobi, many people who arrived for their first jabs were uneasy about when the second doses would arrive.
“My fear if I don’t get the second dose, my immune system is going to be weak, hence I might die,” said Oscar Odinga, a civil servant.
Internal WHO documents obtained by the AP show that the uncertainty about deliveries “is causing some countries to lose faith in the COVAX (effort).” That is prompting WHO to consider speeding up its endorsement of vaccines from China and Russia, which have not been authorized by any regulators in Europe or North America.
The WHO documents show that the U.N. agency is facing questions from COVAX participants about allotments in addition to “uncertainty about whether all those who were vaccinated in round 1 are guaranteed a second dose.”
WHO declined to respond to the issues raised in the internal materials but has previously said that countries are “very keen” to get vaccines as soon as possible, and insisted that it hasn’t heard any complaints about the process.
Concern over the link between the AstraZeneca shot and rare blood clots has also “created nervousness both around its safety and efficacy,” WHO noted. Among its proposed solutions is a decision to “expedite review of additional products” from China and Russia.
WHO said last month that it might be possible to green light the Chinese vaccines by the end of April.
Some experts have noted that Sinopharm and Sinovac, two Chinese-made vaccines, lack published data, and there are reports of people needing a third dose to be protected.
“If there is something that we miss from not having thoroughly evaluated the risks of serious adverse events from these vaccines, that would undermine the confidence in all the good products that we’re using that we know are safe,” said Dora Curry, director of health equity and rights at CARE International.
TRUST WAVERING
Experts are worried that delays will erode faith in governments that were particularly efficient in their vaccination programs and were counting on second doses soon.
“In the absence of high vaccination coverage globally, we risk dragging out the pandemic for several more years,” said Lavanya Vasudevan, an assistant professor at Duke University’s Global Health Institute. “Every day that the virus is in circulation is an opportunity for it to mutate into a more deadly variant.”
Earlier this month, the WHO appealed to rich countries to urgently share 10 million doses to meet the U.N. target of starting vaccinations in every country within the first 100 days of the year. So far, countries have pledged hundreds of millions of dollars to COVAX. But there are simply no doses to buy, and no country has agreed to immediately share what it has.
Bilateral donations of doses tend to follow political lines, rather than to countries with the most infections, and they aren’t nearly enough to compensate for the goals that COVAX has set out. Think Global Health, a data site managed by the Council on Foreign Relations, identified 19 countries that had donated a total of 27.5 million doses to 102 nations as of Thursday.
“You can make a strong argument that we’re better off making donations in crisis and getting the pandemic under control than vaccinating low-risk groups at home,” said Thomas Bollyky, director of the Global Health Program at the Council on Foreign Relations. Bollyky said COVAX was both a great disappointment and the only available option for most the world.
According to the International Rescue Committee, covid-19 cases and deaths last month surged in numerous crisis-hit countries: by 322% in Kenya, 379% in Yemen and 529% in northeast Syria.
Brook Baker, a vaccines expert at Northeastern University, said it was time for WHO and its partners to be more honest with countries.
“WHO and GAVI have repeatedly overpromised and underdelivered, so why should we believe that they will suddenly be able to ramp up production and deliveries in a couple of months?” he said.
Outside the vaccination tents in Nairobi on Thursday, Dr. Duncan Nyukuri, an infectious disease physician, tried to reassure people getting their first doses.
“If you receive the first dose and you fail to receive the second dose, this does not mean that your body will be any weaker or you will be at an increased risk of getting any infection,” he said. “What it means is your body will have developed some immunity against the coronavirus infection. But this immunity is not as good as somebody who has received both doses.”
IRAN IN LOCKDOWN
Iran on Saturday began a 10-day lockdown amid a fourth wave of infections, state TV reported, a worrisome trend after more than a year of the country battling the Middle East’s worst outbreak.
Iran’s coronavirus task force, in charge of determining virus restrictions, ordered most shops closed and offices restricted to one-third capacity in cities declared red zones.
The capital Tehran and 250 other cities and towns across the country have been declared red zones. They have the highest virus positivity rates and the most severe restrictions in place. More than 85% of the country now has either a red or orange infection status, authorities said.
The surge in infections follows a two-week public holiday for Nowruz, the Persian New Year. Millions traveled to the Caspian coast and other popular vacation spots, packed markets to shop for clothes and toys, and congregated in homes for parties in defiance of government health guidelines.
The new lockdown also affects all parks, restaurants, bakeries, beauty salons, malls and bookstores.
There appeared to be no respite in sight to the virus’s spread as Iran’s vaccine rollout lagged. Only some 200,000 doses have been administered in the country of 84 million people, according to WHO.
COVAX delivered its first shipment to Iran on Monday from the Netherlands — 700,000 Oxford-AstraZeneca doses.
The Health Ministry said there were more than 19,600 new infections Saturday, including 193 deaths. The confirmed death toll since the beginning of the outbreak stood at more than 64,000.
Hadi Minaie, a shop owner at Tehran’s Grand Bazaar, said mismanagement was the reason for the surge: “Nobody can say the lockdown should not have been imposed. But better management would have been enforcing it during Nowruz holiday when everywhere was already closed, not now that everyone wants to work and earn a living,” he said.
“Lockdowns are only effective to some extent, but for how long should the people be paying the price,” said Alireza Ghadirian, a carpet seller at the bazaar. He said the government needed to do more to provide vaccines.
Authorities have done little to enforce lockdown restrictions and originally resisted a nationwide lockdown to salvage an economy already devastated by tough U.S. sanctions. A year into the pandemic, public fatigue and intransigence have deepened.
Saeed Valizadeh, a motorcyclist who earns his living transporting passengers and light packages from the bazaar, said if the government paid a stipend to low-income citizens, they could afford to stay home.
“Those who are wealthy have no problem staying home, but we can’t,” he said.
President Hassan Rouhani said several factors played a role in the rising number of cases but that the prime culprit was the U.K. variant of the virus that entered Iran from Iraq.
GERMAN LEGISLATION
In Germany, Chancellor Angela Merkel’s coalition has drafted legislation that would shift the power to impose covid-19 restrictions to the federal government from regional leaders to combat a surge in infections.
Merkel’s administration plans to impose a nightly curfew from 9 p.m. to 5 a.m. in areas where the seven-day incidence rate of infections surpasses 100 cases per 100,000 people for three days in a row. All nonessential stores would have to close, and companies would be required to test employees twice weekly, according to the draft law seen by Bloomberg News. Schools would be closed again in areas with incidence rates of more than 200.
Merkel is moving ahead with the initiative after it became apparent that the country’s 16 states were unable to find common ground. While state leaders may try to soften some of the measures before Cabinet approval Tuesday, parliament could pass the new law as early as Friday.
The proposal’s biggest hurdle is likely to be a vote in the upper house, where state governments are represented and Merkel’s Christian Democratic-led governing coalition doesn’t have a majority.
Merkel and regional premiers have clashed over lockdown restrictions since the start of the pandemic, and some have failed to enforce rules agreed on with the chancellor. Regular meetings to set policy have sometimes dragged on, leaving residents confused about which measures apply to their states.